Florida Senate - 2009                                    SB 1564
       
       
       
       By Senator Wise
       
       
       
       
       5-01164B-09                                           20091564__
    1                        A bill to be entitled                      
    2         An act relating to mental health and substance abuse
    3         services; amending s. 394.67, F.S.; redefining the
    4         term “residential treatment center for children and
    5         adolescents”; amending s. 394.674, F.S.; establishing
    6         priority populations of persons who are eligible for
    7         services funded by the Department of Children and
    8         Family Services; amending s. 766.101, F.S.; redefining
    9         the term “medical review committee” to include a
   10         committee to review mental health and substance abuse
   11         treatment services provided by the department;
   12         repealing s. 394.9081, F.S., relating to target groups
   13         for substance abuse and mental health services;
   14         providing an effective date.
   15         
   16  Be It Enacted by the Legislature of the State of Florida:
   17         
   18         Section 1. Subsection (21) of section 394.67, Florida
   19  Statutes, is amended to read:
   20         394.67 Definitions.—As used in this part, the term:
   21         (21) “Residential treatment center for children and
   22  adolescents” means a 24-hour residential program, including a
   23  therapeutic group home, which provides mental health services to
   24  emotionally disturbed children or adolescents as defined in s.
   25  394.492(5) or (6) and which is a private for-profit or not-for
   26  profit corporation licensed by the agency under contract with
   27  the department which offers a variety of treatment modalities in
   28  a more restrictive setting.
   29         Section 2. Subsections (1) and (4) of section 394.674,
   30  Florida Statutes, are amended to read:
   31         394.674 Client Clinical eligibility for publicly funded
   32  substance abuse and mental health services; fee collection
   33  requirements.—
   34         (1) To be eligible to receive substance abuse and mental
   35  health services funded by the department, a person must be a
   36  member of at least one of the department's priority populations
   37  target groups approved by the Legislature, pursuant to s.
   38  216.0166. The priority populations include:
   39         (a)For adult mental health services:
   40         1.Adults who have severe and persistent mental illness, as
   41  designated by the department using criteria that include
   42  severity of diagnosis, duration of the mental illness, ability
   43  to independently perform activities of daily living, and receipt
   44  of disability income for a psychiatric condition. Included
   45  within this group are:
   46         a.Older adults in crisis.
   47         b.Older adults who are at risk of being placed in a more
   48  restrictive environment because of their mental illness.
   49         c.Persons deemed incompetent to proceed or not guilty by
   50  reason of insanity under chapter 916.
   51         d.Other persons involved in the criminal justice system.
   52         e.Persons diagnosed as having co-occurring mental illness
   53  and substance use disorders.
   54         2.Persons who are experiencing an acute mental or
   55  emotional crisis as defined in s. 394.67(17).
   56         (b)For children's mental health services:
   57         1.Children who are at risk of emotional disturbance as
   58  defined in s. 394.492(4).
   59         2.Children who have an emotional disturbance as defined in
   60  s. 394.492(5).
   61         3.Children who have a serious emotional disturbance as
   62  defined in s. 394.492(6).
   63         4.Children diagnosed as having a co-occurring substance
   64  abuse and emotional disturbance or serious emotional
   65  disturbance.
   66         (c)For substance abuse treatment services:
   67         1.Adults who have substance abuse disorders and a history
   68  of intravenous drug use.
   69         2.Persons diagnosed as having co-occurring substance abuse
   70  and mental health disorders.
   71         3.Parents who put children at risk due to a substance
   72  abuse disorder.
   73         4.Persons who have a substance abuse disorder and have
   74  been ordered by the court to receive treatment.
   75         5.Children at risk for initiating drug use.
   76         6.Children under state supervision.
   77         7.Children who have a substance abuse disorder but who are
   78  not under the supervision of a court or in the custody of a
   79  state agency.
   80         8.Persons identified as being part of a priority
   81  population as a condition for receiving services funded through
   82  the Mental Health and Substance Abuse Block Grant.
   83         (4) The department shall adopt rules to implement client
   84  the clinical eligibility, client enrollment, and fee collection
   85  requirements for publicly funded substance abuse and mental
   86  health services.
   87         (a) The rules must require that each provider under
   88  contract with the department which enrolls eligible persons into
   89  treatment to develop a sliding fee scale for persons who have a
   90  net family income at or above 150 percent of the Federal Poverty
   91  Income Guidelines, unless otherwise required by state or federal
   92  law. The sliding fee scale must use the uniform schedule of
   93  discounts by which a provider under contract with the department
   94  discounts its established client charges for services supported
   95  with state, federal, or local funds, using, at a minimum,
   96  factors such as family income, financial assets, and family size
   97  as declared by the person or the person's guardian. The rules
   98  must include uniform criteria to be used by all service
   99  providers in developing the schedule of discounts for the
  100  sliding fee scale.
  101         (b) The rules must address the most expensive types of
  102  treatment, such as residential and inpatient treatment, in order
  103  to make it possible for a client to responsibly contribute to
  104  his or her mental health or substance abuse care without
  105  jeopardizing the family's financial stability. A person who is
  106  not eligible for Medicaid and whose net family income is less
  107  than 150 percent of the Federal Poverty Income Guidelines must
  108  pay a portion of his or her treatment costs which is comparable
  109  to the copayment amount required by the Medicaid program for
  110  Medicaid clients pursuant to s. 409.9081.
  111         (c) The rules must require that persons who receive
  112  financial assistance from the Federal Government because of a
  113  disability and are in long-term residential treatment settings
  114  contribute to their board and care costs and treatment costs and
  115  must be consistent with the provisions in s. 409.212.
  116         (5) A person who meets the eligibility criteria in
  117  subsection (1) shall be served in accordance with the
  118  appropriate district substance abuse and mental health services
  119  plan specified in s. 394.75 and within available resources.
  120         Section 3. Paragraph (a) of subsection (1) of section
  121  766.101, Florida Statutes, is amended to read:
  122         766.101 Medical review committee, immunity from liability.—
  123         (1) As used in this section:
  124         (a) The term “medical review committee” or “committee”
  125  means:
  126         1.a. A committee of a hospital or ambulatory surgical
  127  center licensed under chapter 395 or a health maintenance
  128  organization certificated under part I of chapter 641,
  129         b. A committee of a physician-hospital organization, a
  130  provider-sponsored organization, or an integrated delivery
  131  system,
  132         c. A committee of a state or local professional society of
  133  health care providers,
  134         d. A committee of a medical staff of a licensed hospital or
  135  nursing home, provided the medical staff operates pursuant to
  136  written bylaws that have been approved by the governing board of
  137  the hospital or nursing home,
  138         e. A committee of the Department of Corrections or the
  139  Correctional Medical Authority as created under s. 945.602, or
  140  employees, agents, or consultants of either the department or
  141  the authority or both,
  142         f. A committee of a professional service corporation formed
  143  under chapter 621 or a corporation organized under chapter 607
  144  or chapter 617, which is formed and operated for the practice of
  145  medicine as defined in s. 458.305(3), and which has at least 25
  146  health care providers who routinely provide health care services
  147  directly to patients,
  148         g.A committee of the Department of Children and Family
  149  Services which includes employees, agents, or consultants to the
  150  department as deemed necessary to provide peer review,
  151  utilization review, and mortality review of treatment services
  152  provided pursuant to chapters 394, 397, and 916,
  153         h.g. A committee of a mental health treatment facility
  154  licensed under chapter 394 or a community mental health center
  155  as defined in s. 394.907, provided the quality assurance program
  156  operates pursuant to the guidelines which have been approved by
  157  the governing board of the agency,
  158         i.h. A committee of a substance abuse treatment and
  159  education prevention program licensed under chapter 397 provided
  160  the quality assurance program operates pursuant to the
  161  guidelines which have been approved by the governing board of
  162  the agency,
  163         j.i. A peer review or utilization review committee
  164  organized under chapter 440,
  165         k.j. A committee of the Department of Health, a county
  166  health department, healthy start coalition, or certified rural
  167  health network, when reviewing quality of care, or employees of
  168  these entities when reviewing mortality records, or
  169         l.k. A continuous quality improvement committee of a
  170  pharmacy licensed pursuant to chapter 465,
  171  which committee is formed to evaluate and improve the quality of
  172  health care rendered by providers of health service, or to
  173  determine that health services rendered were professionally
  174  indicated or were performed in compliance with the applicable
  175  standard of care, or that the cost of health care rendered was
  176  considered reasonable by the providers of professional health
  177  services in the area; or
  178         2. A committee of an insurer, self-insurer, or joint
  179  underwriting association of medical malpractice insurance, or
  180  other persons conducting review under s. 766.106.
  181         Section 4. Section 394.9081, Florida Statutes, is repealed.
  182         Section 5. This act shall take effect July 1, 2009.